Native T 1 value in the remote myocardium is independently associated with left ventricular dysfunction in patients with prior myocardial infarction

Purpose To compare remote myocardium native T 1 in patients with chronic myocardial infarction (MI) and controls without MI and to elucidate the relationship of infarct size and native T 1 in the remote myocardium for the prediction of left ventricular (LV) systolic dysfunction after MI. Materials and Methods A total of 41 chronic MI (18 anterior MI) patients and 15 age‐matched volunteers with normal LV systolic function and no history of MI underwent cardiac magnetic resonance imaging (MRI) at 1.5T. Native T 1 map was performed using a slice interleaved T 1 mapping and late gadolinium enhancement (LGE) imaging. Cine MR was acquired to assess LV function and mass. Results The remote myocardium native T 1 time was significantly elevated in patients with prior MI, compared to controls, for both anterior MI and nonanterior MI (anterior MI: 1099 ± 30, nonanterior MI: 1097 ± 39, controls: 1068 ± 25 msec, P  < 0.05). Remote myocardium native T 1 moderately correlated with LV volume, mass index, and ejection fraction ( r  = 0.38, 0.50, –0.49, respectively, all P  < 0.05). LGE infarct size had a moderate correlation with reduced LV ejection fraction ( r  = –0.33, P  < 0.05), but there was no significant association between native T 1 and infarct size. Native T 1 time in the remote myocardium was independently associated with reduced LV ejection fraction, after adjusting for age, gender, infarct size, and comorbidity (β = –0.34, P  = 0.03). Conclusion In chronic MI, the severity of LV systolic dysfunction after MI is independently associated with native T 1 in the remote myocardium. Diffuse myocardial fibrosis in the remote myocardium may play an important pathophysiological role of post‐MI LV dysfunction. Level of Evidence: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1073–1081.